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Saturday, March 05, 2011

Andrew Wakefield: An Explanation from a Medical Standpoint

A doctor is inherently regarded as a trustworthy individual. The field provides legitimacy. It has real power. In a world where money rules everything the MBBS (or MD or MuDr or what ever combination of letters makes up your standard medical degree) still has a kind of immense power. People still assume we are rich (we are well paid and don’t want for much but the vast majority of doctors do not earn incredibly large salaries. We won’t starve but if we wanted to make money we would be lawyers. Or Homoeopaths)

So a doctor has legitimacy. But we are not infallible. History has repeatedly shown doctors being on both sides of the spectrum of good and bad. In order to give legitimacy to torture many Japanese and German concentration camps hired doctors to do the torture. A doctor gone wrong receives the same respect from the common man and hence is requested to such things

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With this in mind we come to Mr Wakefield. No longer is a doctor but his legacy is entrenched in anti-vaccine culture. He is now the centre of a conspiracy theory his ardent defenders insisting that we have initiated a witch hunt.

That we have altered his results in order to ostracise him and denounce him. We forget that he legitimised the anti vaccine movement. Normally powered by quacks, here was a real doctor to give them a leg to stand on. Unique amongst anti-vaccine movements this is the first one to gain an incredible amount of support from the western public. We normally consider anti-vaccine theories to be the hallmark of third world nations where the rumour is powered by a lack of education and the superstitions of people.

And again we forget what a tragedy this is. Autism is not a joke. These parents are angry because we don’t yet know the cause and the pathology of the disease. So we cannot venture cures. They need a scapegoat, a villain and vaccines provided a handy moustache twirling unnatural villain filled with god knows what.

Vaccinations provide that villain. It’s part of the whole idea that organic food is somehow superior to modern agriculture.

The sheer irony of the anti-vaccine movement is that it exists because of vaccines. Only in a society where there is no fear of such disease can people stand up and say that measles is not that dangerous.

Andrew Wakefield was struck off the medical register of the GMC. The trial was well publicised and a lot of weird things come into the light. As a medical point before we begin to deconstruct his research, autism is a real disorder and occurs either as a regressive disorder where the child simply degenerates socially or as a disorder that is expressed from a really young age where the child fails to develop. Another thing to worry about is that a lot of high grade fevers can cause this kind of behaviour in babies because the brain is still developing and the fever affects it quite spectacularly.

These are the following reasons why the study is flawed and indeed incorrect. All of these are verifiable by a variety of sources. Even by the very same natural medicine advocates who parrot anti-vaccine information.

Andrew Wakefield’s study was from a cohort of 12 children. 12 children does not make a study. A hundred children would be more appropriate study case to declare something as ground breaking as this. This is due to chance.

There was no control, the individuals recruited were “people who thought their kids had mental issues after the administration of the MMR vaccine”. Normally you would see the stats of autism in a population that was being vaccinated and see if they increased or not.

One cannot claim a disease was caused by MMR vaccines by recruiting people whose kids had autism and have had MMR. Correlation does not imply causation.

Mr. Wakefield was working on a lawsuit. He was being paid a fair amount of money for his research and his role as a witness into suing MMR vaccine providers. The payments were surreptitious and heavily influenced his research as the bias was monetary and the amount worked out to nearly half a million pounds.

Individuals in the study turned out to have autistic like behaviour prior to the injections. In one subject the child started regression a month prior to the vaccination. This strongly indicates that either the vaccine had no effect or the MMR vaccine is capable of time travel.

Another child was regarded to have a behavioural anomaly in Mr. Wakefield’s paper. The secondary analysis showed that he had a chest infection as did the original hospital report

It is true that some of these children were autistic and Mr. Wakefield took advantage of them to run incredibly pointless and invasive procedures as he attempted to link both the autism and the bowel disorders to the vaccine. These included spinal taps and colonoscopies.

In many cases parents were not adequately interviewed. One mother claimed the child developed symptoms immediately. Under review, immediately turned out to mean 6 months. Many of the other parents indicated that their children had suspected developmental disorders prior to this but were unsure of them. Not all children develop at the same age and many children often miss developmental stages quite normally. This mother was already of the belief that vaccines caused her child’s autism and so was manipulated to provide a false testimony that came apart under more rigorous questioning.

Under heavy GMC scrutiny the patients were reviewed via looking through the primary diagnosis of various hospitals. Of the 12 strong cohort only one had regressional autism. The rest were not regressive autism but classical autism. 3 out of the 12 didn’t even have either regressional autism or bowel disease. The individual with regressional autism suffered it a full 6 months after the vaccine. There is therefore a severe misrepresentation of data.

Two of the children were brothers who exhibited fits and bowel disorders (common in convulsions). The older was not thought to have autism, the younger was regarded to have Asperger’s syndrome. Brothers would have ruled them out in the study because it would have brought up a genetic element. In addition fits are not regarded to be a behavioural disorder as the child’s behaviour is often normal. A lot of these children’s behaviours can be attributed to the frustration and the pain brought on by the convulsions and bowel issues which were alleviated on defaecation only to return within a day.

When you write a prescription or a request for a test, you often specify what your conditional diagnosis is. For eg. If an individual arrived with drooping eyelids and facial weakness, I would write “Bell’s palsy?” or “Myasthenia Gravis?” Followed by what tests I would wish to run. Andrew Wakefield deleted the question marks turning conditional diagnosis into an actual one. Tampering with diagnosis files is a serious breach of trust.

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ll the recruitment of his cohort was done via anti MMR campaigns with the promise of a class action lawsuit against MMR manufacturers.

And these are just issues of what he did wrong research wise notwithstanding the serious allegation that his so called control were children at his son’s birthday party.

So it’s not merely a case of “he is wrong because it’s nuts” but a case of him being wrong because his research is incredibly faulty or worse biased on purpose in order to make money at the cost of a pharmaceutical company. His research is incredibly flawed even without the onus of the money.

We blindly panicked. No one stopped to think for a second how the individual vaccines never caused this issue but the combined one did.

Lest we forget, even vaccines do have side effects. Almost all medication does. It’s a cost benefit analysis that we can save countless amounts of money and grief by taking a small risk now than a huge risk with the actual disease. Post publishing the UK’s inoculation rate dropped to around 75% and we started seeing outbreaks of Measles, Mumps and Rubella in the population.

Vaccination has always provided people with the cheapest and most effective way of controlling a disease. Mr. Wakefield is responsible for some of the deaths and permanent injuries due to his lackadaisical attitude to medicine and his greed as are the people who funded him